Diphtheria
Clinic
- Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae.
- Symptoms beginning with a sore throat and fever.
- Grey / White patch in throat, which can block the airway and create a barking cough similar to croup.
- Facial / Neck lymphadenopathy.
Extra Throat parthenogenesis
Diphtheria can also involve
- Skin
- Eyes
- Genitals
- Myocarditis (which in itself can result in an abnormal heart rate)
- Paralysis
- Kidney problems
- Bleeding problems due to thrombocytopenia
Diphtheria is usually spread between people by direct contact, through the air, or through contact with contaminated objects. Asymptomatic transmission and chronic infection is also possible. Different strains of C. diphtheriae are the main cause in the difference of lethality, the lethality and symptoms themselves being caused by the exotoxin produced by the bacteria. Diagnosis can often be made based on the appearance of the throat with confirmation by microbiological culture. Previous infection may not protect against infection.
A diphtheria vaccine is effective for prevention and available in a number of formulations. Three or four doses, given along with tetanus vaccine and pertussis vaccine, are recommended during childhood. Further doses of diphtheria–tetanus vaccine are recommended every ten years. Protection can be verified by measuring the antitoxin level in the blood. Diphtheria can be prevented in those exposed as well as treated with the antibiotics erythromycin or benzylpenicillin. A tracheotomy is sometimes needed to open the airway in severe cases.
In 2015, 4,500 cases were officially reported worldwide, down from nearly 100,000 in 1980. About a million cases a year are believed to have occurred before the 1980s. Diphtheria currently occurs most often in sub-Saharan Africa, India, and Indonesia. In 2015, it resulted in 2,100 deaths, down from 8,000 deaths in 1990. In areas where it is still common, children are most affected. It is rare in the developed world due to widespread vaccination but can re-emerge if vaccination rates decrease. In the United States, 57 cases were reported between 1980 and 2004. Death occurs in 5% to 10% of those diagnosed. The disease was first described in the 5th century BC by Hippocrates. The bacterium was identified in 1882 by Edwin Klebs.
Signs and symptoms[edit]
An adherent, dense, grey pseudomembrane covering the tonsils is classically seen in diphtheria. A diphtheria skin lesion on the leg
The symptoms of diphtheria usually begin two to seven days after infection. They include fever of 38 °C (100.4 °F) or above; chills; fatigue; bluish skin coloration (cyanosis); sore throat; hoarseness; cough; headache; difficulty swallowing; painful swallowing; difficulty breathing; rapid breathing; foul-smelling and bloodstained nasal discharge; and lymphadenopathy. Within two to three days, diphtheria may destroy healthy tissues in the respiratory system. The dead tissue forms a thick, gray coating that can build up in the throat or nose. This thick gray coating is called a "pseudomembrane". It can cover tissues in the nose, tonsils, voice box, and throat, making it very hard to breathe and swallow. Symptoms can also include cardiac arrhythmias, myocarditis, and cranial and peripheral nerve palsies.
Diphtheritic croup[edit]
Laryngeal diphtheria can lead to a characteristic swollen neck and throat, or "bull neck". The swollen throat is often accompanied by a serious respiratory condition, characterized by a brassy or "barking" cough, stridor, hoarseness, and difficulty breathing; and historically referred to variously as "diphtheritic croup", "true croup", or sometimes simply as "croup". Diphtheritic croup is extremely rare in countries where diphtheria vaccination is customary. As a result, the term "croup" nowadays most often refers to an unrelated viral illness that produces similar but milder respiratory symptoms